Enjoying the printed surgical guides....
I am by no means an expert in 3d printing but I have enjoyed getting acquainted with the process - thanks for all that post on here and those that I have contacted that helped me to start to utilize this work flow. Here is a case that highlights the blending of CEREC implant planning and 3d printing with the Astra EV line-up.
Initial presentation - history of trauma as a child and this long time patient called with significant discomfort and a mobile tooth - he wanted the most predictable long term solution which I felt was a dental implant. Patient is a medical doctor and did not want a flipper so I milled a splinted temp with teliocad for use as an interim.
Tooth was extracted in June and I waited 5 months for healing
CEREC and Gali images merged and plan completed
I sent this case out to Sicat for guide design and then downloaded and printed the guide. The metal sleeves I got from Sicat directly.
Guide was printed on moonray printed in office - I also printed a model just to verify the fit
Time for surgery, removed splinted provisional
Verified guide
Surgery completed Astra Tech 3.6 X 9mm implant and I did place healing collar, modified provisional to relieve all pressure from surgical site and placed provisional back on. I do use Durelon on these long term provisionals as I have had better success than using temp-bond
I will post final restorative pictures once that phase is complete - suggestions and ideas to do this better are always appreciated!!
Very nice Andrew and awesome documentation. Just a couple of questions.....Did you have primary stability but still wanted the cantilever temp? Do you plan on screw retained or custom abutment?
Andrew. Great job! Looks nice. Any concerns about potential gingival recession and potential loss of gingival collar height on #8?
@ Paul, yes I had primary stability but just went with the cantilever temp since it was most convenient. Plus as I do this more I take it one miracle at a time rather than try to immediate load etc.....the plan will be to restore with Atlantis custom abutment and then cement retained crown. I will plan to utilize a temp in this case to train the tissue down the road before moving to final restorations - this is also a service that Atlantis can provide.
@John - yes this is always a concern on any anterior implant case and I have learned a lot of these boards about the best way to approach this however I have advised the patient that we will do everything we can to control the tissues. The ability to utilize a temp and redo the adjacent crown will help us get a better outcome IMO.
Very cool. I am going to pull the plug on a printer shortly. How much did sicat charge to design it? Is it hard to do the design portion yourself?
@ Brad- I believe it is a $125 charge from Sicat - as far as designing yourself it was my understanding it had to be done with inlab software but I would love to hear what others are executing this work flow
Nice. Judging only by one screenshot is hard but it seems as though with the bone grafting you did you had enough bone to go with an 11mm implant and to position the implant for a screw-retained restoration possibly?
Farhad
On 5/8/2018 at 6:04 am, Andrew Hall said...@ Brad- I believe it is a $125 charge from Sicat - as far as designing yourself it was my understanding it had to be done with inlab software but I would love to hear what others are executing this work flow
Andrew,
I send mine to AA dental and they convert the file in Inlab and send it back to me for in house printing, I use the formlab2. Cost to convert is $20. That is for one or multiple units. If you know what you want this is very good. If you are starting or not sure using SiCat is a great option. Here is the workflow...
Implant plan
Set up for cerec guide 2
this is the surgical plan
Export plan as registered optical impression
export the cmg.dxd file
upload the file to a 3rd party who can convert it, I use Frankie at AA Dental Designs
They send you back the STL file ready to print, we just put it in preform and print it.
Its a very simple work flow once you do it a few times, total cost for stent is around $25.00
@ Farhard - in hindsight yes I likely agree with both, thanks for the critical eye always good to learn
@ Robert - this was one of the first ones I did in house so I did the fail proof sicat option but I need to get to your level - was that case for Astra EV implants, in this every evolving process I need to learn how to get D2 value for these but I am sure it is pretty straightforward. I was more comfortable with the CG2 process with my former implant line
On 5/8/2018 at 9:15 am, Andrew Hall said...@ Farhard - in hindsight yes I likely agree with both, thanks for the critical eye always good to learn
@ Robert - this was one of the first ones I did in house so I did the fail proof sicat option but I need to get to your level - was that case for Astra EV implants, in this every evolving process I need to learn how to get D2 value for these but I am sure it is pretty straightforward. I was more comfortable with the CG2 process with my former implant line
SiCat is a great option as they will tell you if you have any issues. Also you can use your guided system and not cerec guide2. The case I showed was a Straumann. What line did you used to use and why did you change? The D2 is confusing at first but its just the drill size minus 1mm for th size of the cerec guide 2 key.
@ Robert - to answer your question, I used to use and sometimes still do use biomet 3i but I did have some "issues" after with cases so I wanted to look to add another reputable line to my tool belt.
